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OBJECTIVES To examine objectively spatial patterns of osteophytes around the distal end of the femur and to identify distinct subgroups.
The location of osteophytes was recorded using a video camera and digitised computer images were extracted.Multidimensional scaling was used to identify clusters of femora based upon osteophyte location.RESULTS A distinct subgroup of femora was identified with osteophytes present only within the intercondylar notch region.None of these subjects had any evidence of eburnation.CONCLUSIONS This finding adds to an earlier study based on radiographs.Early pathological studies distinguished OA from rheumatoid arthritis based upon the presence of osteophytes and bone remodelling,10 and more recent radiographic based definitions have depended on the definite presence of osteophytes.11-13 However, it has been shown that osteophytes within the knee joint are not necessarily indicative of other features of OA.14 Osteophytes can occur independently of knee symptoms and appear to be an age related phenomenon.15 Osteophyte formation has been shown empirically to be related to enthesophyte formation,16suggesting that the degree to which people form new bone is at least partially dependent on systemic factors and varies considerably from one person to another.
Given the heterogeneity of OA and potential heterogeneity of osteophytes, an investigation of spatial patterns of osteophytes within joints may either provide identifications of subgroups of OA or detect osteophytic patterns that are distinct from OA.
The distribution of osteophytes within the knee joint was described by Kindynis .17 This study, believed to be the first study to examine the distribution of knee joint osteophytes, was based upon an OA group and a crystal deposition disease group using tunnel view, anteroposterior, and lateral radiographs.
Osteophytes located within the intercondylar notch of the femur appear to be a distinct subset, which may occur either as an early stage of knee osteoarthritis or for some independent reason.
Osteoarthritis (OA) of the knee is a common, painful, and debilitating condition.
It affects up to 30% of Western populations over the age of 651 and presents a large burden for the healthcare services.2 OA is characterised radiographically by loss of joint space (indicative of focal cartilage loss), subchondral sclerosis, bony contour remodelling, and the presence of osteophytes. It is heterogeneous with many distinct causal pathways,3 and the concept of OA as a single disease entity has been rejected by some, leading to the use of the phrase “osteoarthritic disorders”.4 There have been attempts to distinguish types of OA based upon the anatomical location of constituent features.
Several studies have sought to describe subgroups of OA within the hip5 6 and within the knee, particularly making a distinction between OA of the patellofemoral joint (PFJ) and OA of the tibiofemoral joint (TFJ).7-9 The presence of osteophytes has commonly been used in the definition of OA.